Individual
MS. SHANNON CARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1061 HARMON AVE, #302, FORT STEWART, GA 31314-5641
(912) 435-5802
Mailing address
1061 HARMON AVE, #302, FORT STEWART, GA 31314-5641
(912) 435-5802
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
305288
TX
Other
Enumeration date
09/12/2014
Last updated
09/12/2014
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